食管癌术后早期肠内肠外营养的对比研究

Comparative study of postoperative early enteral nutrition and parenteral nutrition in esophageal carcinoma

目的探讨食管癌术后早期肠内营养(EN)与肠外营养(PN)对患者营养状况的改善及并发症发生率的影响。方法将106例食管癌根治手术的患者随机分为早期EN组和PN组,手术后第1天开始分别给予营养支持1周,于术前1d、术后8 d检测体重、血常规、肝功能,并观察并发症的发生率。结果EN组体重、红细胞数、血红蛋白、白蛋白及转氨酶下降幅度少于PN组,两组比较P＜0．01,差异有统计学意义。EN组息者元吻合口瘘发生,肺部感染发生率为5．7%,胸腔积液发生率为3．8%,无切口愈合不良者；PN组患者吻合口瘘发生率5．7%。肺部感染发生率28．3%,胸腔积液发生率15．1%,切口愈合不良发生率7．6%；两组比较P＜0．05,差异有统计学意义。结论术后早期EN比PN对食管癌营养状况的改善更好,并发症发生率更低。

Objective To investigate the effect of postoperative early enteral nutrition（EN） and parenteral nutrition（PN） on nutritional status and morbidity in esophageal carcinoma. Methods One hundred and six patients with esophageal carcinoma were randomly divided into two groups, and received enteral nutrition（ n = 53） or parenteral nutrition（ n = 53） continuously for 7 days after operation. The body weight, blood routine test, liver function, and morbidity on postoperative day 8 were compared with those before operation. Results The body weight, red blood cell count, and the levels of hemoglobin, serum albumin and transaminase decreased less in EN group than those in PN group（ P 〈 0. 01 ）. The complication rates of anastomotic fistula, pulmonary infection, pleural effusion and delayed incision healing were 0,5.7%, 3.8% and 0 in EN group, and 5. 7%, 28.3%, 15.1% and 7.6% in PN group. There were significant differences between the two groups（ P 〈 0. 05） . Conclusion Early postoperative enteral nutrition after esophageal carcinoma surgery can improve nutritional status and reduce complications in comparison with parenteral nutrition.